Case Study 16 Jerome Wilson – Solution
The patient has a hypercholesterolemia condition. According to Mayo Clinic (2019), it does not have any symptoms and can only be detected through a blood test…
Case Study 16 Jerome Wilson
Learning Issues
Elevated lipid levels
- Why did the patient stop using the recommended medication?
- Have lifestyle changes helped to lower the lipids level?
- Should the patient increase his energy levels by joining a local fitness club?
Interpretation of Cues, Patterns, and Information
- The patient’s lifestyle in social settings increases the chances of having elevated lipids. The patient has stress keeping up with his family and work responsibilities where he works as a certified accountant in a large accounting firm. According to Wilemon et al. (2020), stress is one of the most significant causes of increased cholesterol levels. In this case, if the patient cannot handle the stress levels he produces effectively, he is likely to have worse levels of lipids, especially LDL cholesterol.
- He also has a family history of hypercholesterolemia, which increases his chances of having the disease. His mother, who is 71 years old, has a history of hypercholesterolemia which is the presence of high cholesterol in the blood (McGowan et al., 2019).
- The patient is also at risk of vascular occlusion due to high cholesterol levels that may block a blood vessel.
Different Diagnoses
- Hypercholesterolemia E78.00
- Vascular Occlusion I70.92
- Varicose Veins I83.90
Diagnostic Options
- Carry out blood tests to check the patient’s cholesterol levels
- Carry out a physical examination to check the recurrent joint pain.
Final Diagnosis
The patient has a hypercholesterolemia condition. According to Mayo Clinic (2019), it does not have any symptoms and can only be detected through a blood test. In this case, the patient does not present any vital signs that could help determine the condition, but it is in his family history, which increases his chances of the same. The patient also takes alcohol and is aged 47, increasing his chances of the disease.
Therapeutic Options
Pharmacological
- The patient’s condition is moderate. In this case, the main focus is to reduce recurrent joint pain. Therefore, I would administer atorvastatin, pitavastatin, or lovastatin to help block the substance needed by the liver to make cholesterol (Sturm et al., 2018).
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Nonpharmacological
- The patient should increase his exercise levels and modify his diet
Educational
- Explain the need to adhere to the given medication.
- Explain to the patient the risk factors that increase his cholesterol levels.
- Explain to the patient how he can manage his condition to improve health.
Social Determinants of Health
- Change how he views his family and work responsibilities to reduce stress.
Follow Up
The patient should visit the clinic once the symptoms worsen.
References
Mayo Clinic. (2019, July 13). High cholesterol – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/symptoms-causes/syc-20350800
McGowan, M. P., Hosseini Dehkordi, S. H., Moriarty, P. M., & Duell, P. B. (2019). Diagnosis and treatment of heterozygous familial Hypercholesterolemia. Journal of the American Heart Association, 8(24). https://doi.org/10.1161/jaha.119.013225
Sturm, A. C., Knowles, J. W., Gidding, S. S., Ahmad, Z. S., Ahmed, C. D., Ballantyne, C. M., Baum, S. J., Bourbon, M., Carrié, A., Cuchel, M., De Ferranti, S. D., Defesche, J. C., Freiberger, T., Hershberger, R. E., Hovingh, G. K., Karayan, L., Kastelein, J. J., Kindt, I., Lane, S. R., … Rader, D. J. (2018). Clinical genetic testing for familial Hypercholesterolemia. Journal of the American College of Cardiology, 72(6), 662-680. https://doi.org/10.1016/j.jacc.2018.05.044
Wilemon, K. A., Patel, J., Aguilar-Salinas, C., Ahmed, C. D., Alkhnifsawi, M., Almahmeed, W., Alonso, R., Al-Rasadi, K., Badimon, L., Bernal, L. M., Bogsrud, M. P., Braun, L. T., Brunham, L., Catapano, A. L., Cillíková, K., Corral, P., Cuevas, R., Defesche, J. C., & Gidding, S. S. (2020). Reducing the clinical and public health burden of familial Hypercholesterolemia. JAMA Cardiology, 5(2), 217. https://doi.org/10.1001/jamacardio.2019.5173
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